Resected Colorectal Liver Metastases: Does the Survival Differ According to Postoperative Chemotherapy Regimen?

Background and Objectives: We compared clinical outcomes in patients who were treated with different chemotherapeutic regimens after resection of hepatic metastases from colorectal cancer (CRC). Methods: Between August 2001 and June 2008, 156 patients who entered into chemotherapy of adjuvant intent after hepatic metastasectomy were reviewed retrospectively. Results: Of the 156 patients, 58 patients were treated with oxaliplatin/fluoropyrimidines (group I), 48 with irinotecan/fluoropyrimidines (group II), and 50 with fluoropyrimidines alone (group III). In the univariate analysis, there was a marginally significant difference among the three groups with respect to the disease-free survival (DFS): 23.4 months in group I, 14.1 months in group II, and 16.3 months in group III, P = 0.088). Group I showed better DFS when compared to the other two groups combined (group II and III) (P = 0.03). Multivariable analysis showed a marginally significant gain in the DFS for group I (P = 0.068). Multiple metastases (P = 0.045) and positive resection margin (P = 0.003) were significantly associated with poorer DFS. Conclusion: Postoperative combination chemotherapy of oxaliplatin/fluoropyrimidines seemed to show better DFS when compared to fluoropyrimidine monotherapy or irinotecan-based combination in patients who underwent liver metastasectomy. J. Surg. Oncol. 2009;100:713-718. (C) 2009 Wiley-Liss, Inc.